Prescription for inequality

By Michelle Chen Mar 04, 2009

The recent discussions on race and health in the activist community coincide with a festering crisis in one part of the immigrant population: the treatment of detainees–marginalized by law from the mainstream health system–is a marker of the depth of medical disenfranchisement in this country. According to testimony by Immigration and Customs Enforcement officials, presented yesterday in a House subcommittee hearing, more than 1.7 million people have passed through ICE’s detention system since 2003, and an estimated 442,941 detainees be held by ICE this year. In fiscal year 2008, ICE reportedly spent more than $128 million to provide health care to detainees; services include regular health monitoring for immigrants, translation services, and treatment for various conditions. About 34 percent of the detainees screened in FY 2008 “were identified as having chronic conditions, including hypertension, diabetes, and/or mental health issues.” (The Government Accountability Office has begun an independent probe of of the detainee health system.) With such seemingly comprehensive care, it’s no wonder that the ACLU wants to know why one detainee wasn’t able to testify yesterday:

ACLU of Rhode Island client Hiu Lui Ng, a 34-year-old Chinese detainee who died in August 2008 at the Wyatt Detention Facility in Central Falls, Rhode Island, was diagnosed with terminal liver cancer and a broken spine a few days before he died. For months, Ng had told prison officials about his excruciating pain, but guards and medical staff at Wyatt continually accused him of faking his illness. Despite Ng’s inability to walk, he was frequently denied use of a wheelchair, including when his attorney sought to visit him. A week before Ng’s death, officials shackled his hands, feet and waist and dragged him while he screamed in pain to a transport van. Parts of this abusive treatment were captured on videotape.

ICE Director of Detention and Removal Operations James Hayes emphasized that one of its “challenges” as a health care provider is that “90 percent of our detainee population comes from 10 of the world’s most underdeveloped nations and have generally not received adequate health care prior to entering ICE custody.” Noting the harrowing and controversial deaths of detainees in recent months—and drawing vague comparisons with other detention facilities—Hayes concludes, “given the generally poor health of detainees who enter ICE custody, the comparatively low death rate among ICE detainees provides evidence of the extraordinary measures ICE takes to prevent the death of any ICE detainee in our care.” Got that? It’s actually a testament to the quality of ICE-run health care that there haven’t been more detainee deaths. Setting aside the disturbing circumstances surrounding these supposedly few fatalities, the government is touting the medical care offered at detention centers as an improvement on what patients would have gotten outside the system. You could read this as a PR smokescreen, or a perverse indictment of the medical apartheid afflicting the immigrant community—those locked behind bars as well as those toiling at the base of the economy. Either way, immigrant status in this country seems to be a tacit prescription for unequal health treatment—whether through the willful ignorance of government policy, or the malign neglect of the law enforcement system.